| NPI | 1558424804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: WA LD00001031) |
| Additional Taxonomies | 231HA2400X Audiologist Assistive Technology Practitioner (Licence: WA LD00001031) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2016-03-28 |